Prologue from Childhood Trauma Recovery: The Email Conversations With My Therapist that Helped Me Overcome Childhood PTSD

This is the moving, true story of my therapy journey to overcome complex post-traumatic stress disorder (C-PTSD) due to early childhood abuse at the hands of both my parents. It’s told through an exchange of intimate emails I had with one of my therapists, David Pike, over the course of two years. The therapeutic relationship develops as we go deeper into therapy. These emails were all communicated between therapy sessions and are presented as they were written at the time, with only minor editing to protect the confidentiality of some third parties.

My motivation for writing this book is to bring hope to others who have suffered C-PTSD or know someone with it. When I was battling it, I thought I would never come through the other side and be able to live a ‘normal’ life, free of the symptoms of C-PTSD, such as flashbacks and panic attacks. I wanted to write this book to bring hope to others that healing from C-PTSD is possible. It is possible to go from surviving to thriving, even though it takes time to get there.

What is C-PTSD, and why is it so difficult to treat? I have always struggled to articulate the impact that it has had on my life. It isn’t something that’s easy to describe to people who have never experienced it. A physical illness is much easier for people to understand. However, I recently gave a Toastmasters speech on it in which I had to use storytelling and figurative language such as metaphors and similes. I have included an excerpt from it here to illustrate how C-PTSD has affected me, in the hope that it will give you an understanding of its impact on my life:

Many years ago, there was a young girl whose parents badly abused and neglected her throughout her childhood, until she eventually left home to go to university. Unfortunately, even after she’d left home, she was still plagued by the after-effects of being abused by the very people who were supposed to love and care for her. As a young girl, she had vowed to herself that she would overcome the horror of her childhood, but as an adult, she found the effects of the trauma still haunted her.

After graduation, the trauma continued to negatively impact her whole life. She found living with unresolved complex PTSD is like trying to plan your future when your house is on fire. You don’t. You focus on getting out of the house because your immediate survival depends on it. Until she could resolve the trauma, she couldn’t focus on other areas of her life such as work and relationships. This means, for most of her life she was focused on trying to get out of the burning house rather than planning and working towards her future.

Her recovery from the complex trauma was hampered by the difficulty of finding a therapist who could treat it. This was because going to a therapist who generalises in lots of different mental health problems was like having cancer and going to your GP for treatment instead of an oncologist. Your GP will have knowledge about cancer, but he or she won’t understand the best course of effective treatment for you and your particular type of cancer. He or she could unwittingly make it worse. Complex PTSD is the same.

To give you an idea of what I mean by this, I’ll return to my burning house metaphor. Complex trauma isn’t your average house fire, it’s more like a raging inferno. She found that if the therapist didn’t have the right tools to treat complex trauma it was like fighting a raging inferno with a handheld fire extinguisher. Handheld fire extinguishers are perfectly adequate for putting out a small fire, such as one in a wastepaper basket, and used properly, they will stop a fire spreading. But her trauma wasn’t a wastepaper basket fire. The help she tried to enlist over most of her life didn’t help her, because they didn’t know how to fight raging infernos, they only knew how to fight little fires.

Unfortunately, the way trauma affected her brain meant she couldn’t remember anything about what happened, so she didn’t know what she was dealing with. This meant she didn’t know to look for someone who knew how to fight that kind of fire. And all the while the fire was getting more and more out of hand. It was destroying more and more of her life.

Her trauma was also a blaze that was invisible to everyone else. To people on the outside, there appeared to be nothing the matter, so no one could understand why her life wasn’t working and why she was struggling so much.

Healing her mind afflicted with complex PTSD was akin to healing a physical wound to her body. Given the right conditions the lesion will heal by itself; whereas a festering laceration will be prevented from healing by the disease. Her trauma was like a putrefying wound in the brain; it wouldn’t heal, and like a throbbing, physical wound, it constantly distracted her from being able to concentrate on other things. Give her brain the right conditions, however, and it would also heal. EMDR therapy was like the mind equivalent of cleaning and disinfecting an infected cut. The EMDR cleaned the infection of the brain, the trauma, and thus allowed it to heal.

Even when she found someone who knew how to treat complex trauma, overcoming her childhood trauma wasn’t a linear process – like climbing a ladder – it was one fraught with setbacks even when she did make progress.

Before the trauma had been resolved, her brain was like an overfull cupboard, with a door that had a habit of opening of its own accord. When the door opened, the tins – which represented her thoughts – frequently and without warning would fall out and hit her on the head and body. After the trauma had been resolved, the cupboard was more like an orderly stacked cupboard; the tins remained neatly stacked on the shelves until she chose to open the cupboard door and take them out and the faulty hinge had largely been fixed.

Events leading up to the start of this book

In early 2016, I was coming to the end of a year of therapy through Improving Access to Psychological Therapies (IAPT) for C-PTSD. IAPT is therapy available on the UK’s National Health Service (NHS) through primary care. I had gone for help with work, something I had struggled with since graduating from university with a degree in biological sciences in 1997. I had gone to university despite pressure from my mum not to go; she hadn’t wanted me to have a university education because she hadn’t had one. I had a degree, but I’d never had a career. I had a dearth of knowledge about how to even have a career. My mum had wanted me to remain trapped in poverty doing work I loathed because she had despised her own job after having children. I had worked briefly in a couple of labs related to my degree, then temped as a secretary/PA at board level for seven years, before attempting to work freelance as a writer for a few years. I’d then stopped working completely and disappeared inside my personal version of hell, despairing that I would never be able to overcome my issues with work and fulfil my potential.

I was desperate for help with work and had told my NHS therapist, “Please help me, I cannot get myself out of this.” I had been unable to articulate what ‘this’ was, I just felt it as a deep, consuming terror that I had carried for the whole of my life. To anyone on the outside, my issues with work seemed to be nothing more than laziness, procrastination and a lack of motivation and work ethic. Indeed, I had bought this logic myself; if I could just get over my procrastination, I reasoned, then I would be able to do something about it. I’d been called lazy by family members, and lost friends over my lack of working. I hated meeting new people because they would ask me what I did for a living and I would lie and tell them that I was still working freelance as a writer, because the fear of rejection and shame of telling them I was not working were intolerable. But the lying would also attack my self-esteem, leaving me feeling sullied and unclean inside. I seemed capable and articulate, so was it that I just couldn’t be bothered?

The thing is I did want to work. Not working gnawed away at my integrity and self-respect. Thanks to being self-taught in philosophy, I knew that life isn’t self-sustaining, it requires action. Which meant that if I wasn’t working then someone else was having to sustain my life for me. The person who was sustaining my life was a friend whom I had helped over the course of three years to get out of an unhappy 21-year relationship and to get a divorce from her husband. This friend and I were unalike, had very different values and very little in common, and the friendship was strained. This relationship was compounding my problems. She wasn’t good for me, and I wasn’t good for her. Living with her plunged me into a deep depression. I was living a twilight existence, lacking purpose and direction. I once saw a cartoon depicting hell: it was living life on Earth without a purpose or meaning; being directionless. This matched my experience.

I was in this terrible bind of wanting to work, but the thought of work filled me with mortal dread that was paralysing. The mortal dread I felt was something I was unable to grasp nor articulate; it had a nebulous quality to it. Not working was causing me crippling shame. I couldn’t talk about it to anyone because I was so ashamed of it, and it’s hard to get help with something if you can’t talk about it. I also wanted help but was afraid of being forced into work that I would find unbearable; previous work that I’d done had left me stressed, anxious, depressed and miserable. I wanted to do work that was meaningful to me but believed that I couldn’t make a living from doing so.

I have only recently discovered that my personality is such that I crave intellectual stimulation in my work. This insight came about through reading a book called ‘I Just Love My Job! The 7P? Way to a Job You Love Based on Who You Are’ by Calvert, Durkin, Grandi and Martin. If I can’t get this intellectual stimulation, then unlike someone who can tolerate mundane work if they focus on the people aspect of their work, this simply isn’t sufficient for me. I really would rather have been dead than spend the rest of my life doing work that I hated. I had told my NHS therapist this, but he had assumed it was nothing more than hyperbole, whereas I had thought I was being absolutely clear about where I stood with this. I was reaching the end of the line. I was getting older and I was convinced my work options were hopeless. I’d never had a permanent job, so no one would want to employ me. I knew that I didn’t really want to work for anyone else, but I didn’t believe that I could make a living from being self-employed either. I was locked into a spiral of self-defeating beliefs.

I knew I needed therapy to help me, but by not working, I didn’t have any money to pay for it. I didn’t want to seek therapy on the NHS because I was crippled by a dread of doing so. I had temped in a community mental health team and had found the experience dehumanising; I had been left wondering if they still saw the patients as people or just their mental health problems.

This meant I was like a ball in a pinball machine, constantly being pinged from one barrier to the next, and never making any kind of progress. I spent a lot of time working on this, and eventually I had to risk my fears materialising because I wasn’t going to get anywhere if I didn’t.

Help, but not with what I wanted help with

Unbeknownst to me at the time, there was terrible trauma underpinning my lifelong issues with work. However, this IAPT had a policy that they didn’t help with work issues, so despite specifically going for help with work, my therapist chose to focus on dealing with what they called ‘First Worst’. These were the earliest memories of abuse, the idea being that processing the early memories of trauma would resolve later traumas as well. The implication was that doing so would somehow also help my work issues. This didn’t happen.

The aftermath of therapy

After a year of therapy on the NHS, I was left severely depressed, anxious, dissociating, and with flashbacks and panic attacks, because my therapist didn’t understand the importance of keeping me within the ‘window of tolerance’ (keeping me under a threshold so that he didn’t run the risk of re-traumatising me). Instead, his repeated encouragement that I just ‘push through’ the overwhelming feelings associated with the abuse had re-traumatised me. I’d run out of sessions while still in the middle of processing my extensive childhood trauma and I couldn’t have more sessions because they weren’t allowed. More damagingly, I was no further forward with work either. To compound matters, my therapist had assumed my work was nothing more than distress intolerance, and nothing I told him would change his mind on this. IAPT had a policy of not helping with work, so he didn’t want it to be a problem for me. His presumption was that if I just got back into work, then eventually I would find a way to do something that was more interesting for myself, such as becoming a therapist. Missing the point that I hadn’t managed this up until now so it was unlikely I’d suddenly be able to do so, especially as I had no experience of having a career. He acted as though I just needed a bit of exposure to work and all my fears would dissolve.

Therapy with a new therapist and the reason for this book

On Monday 14 March 2016, a month after my therapy had finished, I started work as a bank administrator on the NHS. ‘Bank’ meant that I was on a zero-hours contract. Ten years after I’d left the workforce, I was back where I started, only this time I was even worse off; I was even further down the career ladder, and I was doing work that was even more unsuited to me as a person. I was now working as an administrator, whereas previously I had been working as a PA at board level. To me at that time, it seemed my situation was hopeless. I had been desperate for help with something that I had been struggling with for the whole of my working life, and that I had been unable to resolve by myself. Not only had I not received help with the thing I sought help for, meaning I was no further forward after a year of therapy, but I was now in a worse position. During that first day back at work, I remember thinking, did my IAPT therapist ever have any intention of helping me find work, or had it always just been a ruse to get me into any old job? It felt like a betrayal, which was devastating, and I lost hope and gave up.

To give you an idea of just how hard I had tried up until this point to overcome my problems by myself, I had overcome my fear of public speaking, even though it’s often quoted that more people would rather die than speak in public, and I had passed my driving test after seven attempts despite severe driving anxiety. Thanks to philosophy, I had reasoned my way out of my crippling fear of death. I had overcome the terrorisation of heaven and hell and the brainwashing from my religious upbringing. But overcome my fear of work? No. That was beyond me. That wasn’t something I was able to reason my way out of because the thinking part of my brain shut down whenever I tried. I had also bought into the opinion that it was nothing more than laziness and procrastination on my part. I was trapped by the belief that if I just overcame my procrastination, I would be okay.

Fortunately, near the beginning of my third block of therapy I received a small inheritance following the death of my mum. I had received excellent advice from a friend who recommended that I didn’t spend this money, but instead saved it and either put it towards a deposit for a house or bought a studio flat somewhere cheap and rented it out, so that I would have an income. This meant I was very reluctant to spend the money, so reluctant that in my muddled state I was considering killing myself rather than risk spending the money on therapy.

A Dutch friend then advised me that I would be better off spending some of my inheritance on therapy in the hope that it would mean I was able to earn a living doing something meaningful to me, rather than keeping my inheritance intact but killing myself. Good advice, but it’s testament to my inner turmoil that I had been unable to come up with this solution myself. When I later reminded him about this event, he hadn’t realised I was serious about killing myself. It’s probable that I downplayed it; I was terrified of being sectioned (hospitalised in a mental health hospital against my will). For this same reason, I was careful not to tell any of my friends in the UK just how much I was struggling, because I thought they were legally bound to inform the authorities if they thought I was suicidal. I had told my IAPT therapist that I knew my suicide would be spontaneous, and that I wouldn’t phone anyone because I wouldn’t believe that anyone could help me. He hadn’t picked up on this as a risk for suicide, astonishingly. This is also why I didn’t phone the Samaritans when I’d tipped over the edge from thinking about it to acting on it.

By the time I started my first day at work, I had spiralled down into severe depression, and suicide seemed like my only option. I would rather have been dead than spend the rest of my life doing work that I hated. I was very clear about this, and it seemed I had no other options.

New therapist, new hope

I had a session with a new, private therapist (David) booked for the following morning. My plan was to walk down to my local train station after this session and throw myself in front of a high-speed train. If I attempted to kill myself, I wanted to be sure that I definitely died and didn’t survive with horrific injuries to contend with. I had reached the point where I didn’t believe that I could ever have meaningful, fulfilling work. The thought of spending the rest of my life doing what I had done previously was intolerable to me. I honestly believed that I would be better off dead.

I woke up on the morning of 15 March 2016, with this first therapy session booked with my new therapist. I was wondering why on earth I was bothering with another therapist, when it seemed that all therapists were the same. I had been convinced by my IAPT therapist into believing that the only way for me to resolve my issues with work was by exposing myself to work, and yet doing so was re-traumatising for me. It seemed that I was in a no-win situation. I couldn’t progress without therapy, yet if I had therapy, my therapist was just going to re-traumatise me. The only reason I decided to keep my first therapy session with this new therapist was because I had already paid for it. The mind plays a strange trick: if I was going to kill myself, what did it matter about a wasted therapy fee? However, I decided that I would have the therapy session because I had paid for it. If I hadn’t, I doubt I would still be here.

I kept my 9.30am appointment, telling myself that I could kill myself afterwards. I am eternally grateful for the part of me that made me attend that therapy session.

Throughout the therapy session, I was distracted by the conviction that I was going to kill myself afterwards, but I wasn’t going to tell my therapist this. Why not? Because I had gone past the cry-for-help stage; telling my therapist would have been asking for help, whereas I was convinced my situation was hopeless and that no one could help me. Additionally, I was terrified of being hospitalised. This may seem ironic that the institution that is supposed to prevent me from killing myself is the same that would have prevented me from telling my therapist that I was suicidal. However, the research suggests this is a common experience and my fears were motivated by trauma: my trauma was from being forced to do something I didn’t want to do, and being hospitalised would involve being forced to do something I didn’t want to do.

I still had this mindset about killing myself after the session right up until towards the end, when my therapist uttered these words after explaining about keeping me within the window of tolerance: “I will not try and force you to do anything you don’t want to do.” I was flabbergasted; here was a therapist who seemed to understand trauma. He wasn’t going to force me into work! I could have therapy that was going to help me rather than simply re-traumatise me! In the few moments afterwards, I had to reorient myself to carrying on living my life; I didn’t need to kill myself. The relief was overwhelming. It rendered me speechless for several minutes.

In those few moments, I had gone from despair to hope.

How this book is structured

The main body of this book starts with the first emails I exchanged with David where I request an initial therapy appointment; the one I describe above. Between therapy sessions I would email him to get help when I was struggling. Doing so helped to develop the relationship that I had with him, which made all the difference to my healing. This email exchange is the topic of this book.

To read the rest of this book, please click on this link: Childhood Trauma Recovery: The Email Conversations With My Therapist That Helped Me Overcome Childhood PTSD